Michael Yochelson, M.D., Medical Director, NRH Brain Injury Program and Principal Investigator for the study.

Post-traumatic headache is one of the most common and long-lasting symptoms following mild traumatic brain injury (MTBI) – with an estimated four million Americans suffering from the persistent problem. With more than 1 million incidents of MTBI occurring each year, the result of everything from motor vehicle accidents, occupational and recreational mishaps, and combat (particularly “blast injury”), MTBI headache represents a major health problem. In combination with other common symptoms following MTBI, the condition can be quite disabling. Post-traumatic headache also is a frequent problem even when injuries may not involve MTBI, such as the case of someone who suffers a cervical injury in an accident.

Treatment of post-TBI headache is often very complicated and regretfully often does not result in optimal symptom relief. In addition, many medications used to treat headache have undesirable side effects that limit their effectiveness, because patients may be reluctant to use them as prescribed. But now there is some new encouraging evidence that a class of medications called triptans may prove effective for treating post-TBI headache.

The National Rehabilitation Hospital is participating in a multi-center study examining whether the triptan drug naratriptan (approved to treat migraines) may prove effective in treating headache in individuals who have sustained a MTBI. This study, funded by GlaxoSmithKline, will enroll eligible subjects in a 30-day trial of medication or a placebo, under double-blind conditions.

In addition to measures of headache relief, subjects will also have physiological measures taken, and complete quality of life questionnaires and a computerized battery of neuropsychological tests administered on a hand-held computer.

Important outcome measures include the number of days subjects experience headaches, the impact of headaches on daily functioning, and potential changes in neuropsychological functioning resulting from taking medication. It is anticipated that data from this study will provide important information about whether triptans are a useful tool for treating headaches in individuals with MTBI.

For more on TBI research at the National Rehabilitation Hospital, download the Summer 2008 issue of Research Update.